Is Enhanced Recovery After Surgery Pathway (ERAS) Influential in Reducing Length of Patients Stay in Colorectal Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Salah Nashi AlOtaibi*
Consultant Cardiac Anesthesiologist, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
*Corresponding Author: Salah Nashi AlOtaibi, Consultant Cardiac Anesthesiologist, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
March 29, 2021; Published: May 29, 2021
Background: A systematic review and meta-analysis was conducted after identifying from the literature that enhanced recovery after surgery (ERAS) pathway reduces length of stay (LOS) and control health expenses after colorectal surgery. This review paper follows PRISMA guidelines and retrieved randomized controlled trials (RCTs) to assess the efficacy of ERAS pathway in reducing LOS after colorectal surgical discharge. In addition, this review paper aims to evaluate other post-operative complications such as mortality rates, costs, and readmission rates with the implementation of ERAS pathway.
Methods: Eligible RCTs (n = 17) were included in this review paper from PubMed, CINAHL Plus, EMBASE, and MEDLINE from January 1st 2011 and March 31st 2020. Each trial was cross-checked in terms of its publication bias and quality rigor. Restrictions were set for English publications only.
Results: A total of 7500 patients were included in 17 RCTs. The ERAS pathway was associated to shorter mean LOS [MD = -1.07 days, (-1.99, -0.15), p for effect < 0.001, p for heterogeneity < 0.0001, I2 = 98%] without increasing readmission rates and cost associated to colorectal surgery. Mortality rates were also controlled with the implementation of ERAS pathway as compared to standard care.
Conclusion: There was significant evidence in reduction in mean LOS after colorectal surgery with the implementation of ERAS pathways. The appropriate ERAS pathway implementation results in controlling other secondary complications.
Keywords: Colorectal Surgery; ERAS; Length of Stay; Randomized Controlled Trials
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